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Thyroid UK
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Confused about ferritin and serum iron levels

This is a bit long, so I apologise in advance.

I have read, on this forum, that ferritin levels should be optimal for thryoidees and that ferritin is the storage of iron. But I'm a little confused with my ferritin results and serum iron panel results and wondered if anyone has any wisdom to share about them and how it might affect the thyroid functioning well?

My ferritin level is 116 (13-150)

My folate level is 15.1 (4.6-18.7)

My serum iron panel is:

Iron 12.7 (6.6-26.0)

Unsaturated iron binding 58.1 (20-66)

Total iron binding capacity 71 (41-77)

Iron binding saturation 18 (15-50)

My B12 was 295 in 2012 (211-911)

My MCHC level is 315 (320-360)L!

My MCH level is 27.7 (27.0-33.5)

These 2 levels have been highlighted as low for a few years (after getting a copy of as many blood results as possible earlier this year)

My MCV is 'normal' 88.2 (80-99)

From what I have gathered my total iron binding capacity maybe a bit high and the iron binding saturation a little low (even though they are both in range) indicating some form of anemia. Also the MCHC and MCH being low has something to do with hemoglobin and red blood cells which may also indicate some form of anemia. But I don't understand how I would treat this, if this were the case, since my ferritin levels are good.

Any advice or wisdom would be much appreciated and thanks for reading.

7 Replies

Hi Rebekah40, you don't say if you are feeling unwell, tired, etc. when my ferritin levels were low (44mwhen they need to be 70-75 or higher) but "within normal range" for GP, I felt really awful, tired, nauseous At times, no energy, brain fog, no drive, bloated, putting on weight etc. Taking a liquid iron supplement transformed me in less than 24 hours until now I have to take them every day (until my levels improve in doubt). I asked GP if I was anaemic and GP looked at my haemoglobin levels which was fine and said I wasn't anaemic. Do you know your haemoglobin level?

Sorry I can't be more helpful but I'm sure the are plenty of people on the forum who can help.

Hope all is well with you soon!


Thank you Mystory4u. I have been having many symptoms for years including what you mention - fatigue, weight gain, pain, bloatedness, brain fog, skin pigmentation, chest pains. I have been fatigued and have had chest pains since being a teen. I am taking 50mcg of levothyroxine, which I have started recently. I am confused because my ferritin level looks good. My haemoglobin level is 134 (115-155).


Rebekah40, if you've only started the T4 (levothyroxine) recently you will need to give yourself more time before you start to really notice the improvements on the T4. (Assuming that your other important readings are good such as the ferritin, vit D, Vit B12, and the ones you have shown do look okay, don't they?) also you are on quite a low dose of T4 (I'm on 600ug a week which is 5 x days on 100 and 2 x days on 50, for instance.) do you have your most recent TSH, free t3 and free t4 levels to post? Often people on the forum can tell you if you are under medicated by these. When did you start T4? Also you should not eat diary or take calcium within four hours of taking your levo and also not take other meds or supplemtents around the same time. I even take my iron supplement in the afternoon to avoid issues with it blocking the uptake and conversion of my T4. take your levo on an empty stomach too. I am trialling a gluten free and dairy free diet to see if it helps relieve some of the symptoms I am still battling with even though my blood test results look okay from a thyroid point of view.

Hope someone eel will give you more info and I'm still very much a learner on this forum.

Sorry to hear you are struggling and hope things improve. We have to learn so much so that we can advocate for our own health! :)


Yes, you're right I do need to give the thyroxine more time to work. Some of my readings do look good, not sure about the B12 I think that is a little low. I make sure I take my levo on an empty stomach (from reading everyone's comment's on this forum). I will try and post my thryroid results later and I am like you learning a lot from yourself and others on this forum. Thanks :)


I would definitely agree that your B12 is too low. It needs to be as close to the top of the range as possible.

The best supplement is sublingual methylcobalamin. Search for it on Amazon, look at the reviews, decide which one you want to buy, then shop around for the best price.


Ferritin can be elevated by inflammation or chronic disease or bacterial infection or parasites. It is a self-defence mechanism by the body. Suppose you had a chronic low-level bacterial infection somewhere - the gut or the lungs perhaps, but it could be anywhere. Those bacteria need iron to survive and reproduce. The body reduces the chances of that happening by restricting access to iron - and it does that by storing it in the form of ferritin and leaves only the minimum necessary for you.

The existence of inflammation can be tested by doing some blood tests :


If levels come back showing you have inflammation then the next task is to find out where it is and what is causing it, and then it has to be fixed. And that is the difficult bit...


Humanbean thank you for this explanation. This makes sense about the inflammation/chronic disease and elevated ferritin. I had a high ESR and finally got a dignosis of seronegative spondylarthropathy and joint hypermobility in 2012 and this year fibromyalgia. My ESR has now gone down. Your clarification on the body storing iron in the form of ferritin and restricting access to iron is interesting - I didn't know this. Maybe this is what has happened in my case. :)


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